动态对比增强磁共振成像指标与表观扩散系数值在前列腺癌诊断中的应用价值  

Application value of DCE-MRI index and ADC value in the diagnosis of prostate cancer

作　　者：马小静[1] 郝巧梅 张海三[2] Ma Xiaojing;Hao Qiaomei;Zhang Haisan(Department of MRI Room,Anyang Regional Hospital of Puyang City,Henan 455000China)

机构地区：[1]河南省濮阳市安阳地区医院磁共振室,455000 [2]新乡医学院第二附属医院磁共振室

出　　处：《实用医学影像杂志》2024年第6期426-429,共4页Journal of Practical Medical Imaging

摘　　要：目的分析动态对比增强磁共振成像(DCE-MRI)指标联合表观扩散系数(ADC)值在前列腺癌诊断中的应用价值。方法选定濮阳市安阳地区医院2019年1月至2024年2月就诊的86例前列腺癌患者设置为恶性组,同期86例前列腺增生患者设置为良性组,进行DCE-MRI诊断、扩散加权成像(DWI)诊断,比较2组DCE-MRI指标参数、ADC值、前列腺癌术后格里森(Gleason)评分,Pearson分析DCE-MRI指标参数[血管外细胞外间隙容积比(Ve)、速度常数(Kep)、容量转移常数(Ktrans)]、ADC值与Gleason评分的相关性,受试者工作特征曲线(ROC)分析Ve、Kep、Ktrans、ADC值对前列腺癌的诊断效能。结果恶性组Ve、Kep、Ktrans均较良性组高(P<0.05)。恶性组ADC值较良性组低(P<0.05),恶性组Gleason评分较良性组高(P<0.05)。Ve、Kep、Ktrans与Gleason评分均呈正相关性(r值=0.38、0.40、0.40,P<0.05),Gleason评分与ADC值呈负相关性(r值=-0.37,P<0.05)。Ve、Kep、Ktrans、ADC值联合诊断前列腺癌的Re曲线下面积(AUC)是0.916,95%CI置信区间是(0.852,0.954),Ve、Kep、Ktrans、ADC值联合灵敏度(95%)较单一诊断(69%、76%、73%、79%)高(P<0.05),Ve、Kep、Ktrans、ADC值联合诊断特异度(80%)与单一诊断(77%、81%、82%、79%)比较,差异无统计学意义(P>0.05)。结论Ve、Kep、Ktrans联合ADC值可提高对前列腺癌的诊断灵敏度,弥补了单一诊断的不足,值得借鉴。Objective To analyze the value of dynamic contrast-enhanced magnetic resonance imaging(DCEMRI)indicabrs combined with apparent diffusion coefficient(ADC)in the diagnosis of prostate cancer.Methods A total of 86 patients with prostate cancer treated in Anyang Regional Hospital of Puyang City from January 2019 to February 2024 were selected as the malignant group,and 86 patients with prostate hyperplasia during the same period were selected as the benign group,and DCE-MRI diagnosis and diffusion-weighted imaging(DWI)diagnosis were performed.DCE-MRI inchcstns parameters,ADC values,and Gleason score after prostate cancer surgery were compared between the two groups.Pearson analyzed the correlation between DCE-MRI parameters[extravascular extracellular space volume ratio(Ve),velocity constant(Kep),volume transfer constant(Ktrans)],ADC values,and Gleason score.ROC was used to analyze the diagnostic efficacy of Ve,Kep,Ktrans,and ADC values in prostate cancer.Results Ve,Kep,and Ktrans in the malignant group were higher than those in the benign group(P<0.05).The ADC value of the malignant group was lower than that of the benign group(P<0.05),and the Gleason score of the malignant group was higher than that of the benign group(P<0.05).Ve,Kep,and Ktrans were positively correlated with the Gleason score(r=0.38,0.40,0.40)(P<0.05),and Gleason score was negatively correlated with ADC score(r=-0.37,P<0.05).The AUC for the combined diagnosis of Ve,Kep,Ktrans,and ADC values was 0.916,and the 95%CI confidence interval was(0.852,0.954).The combined sensitivity of Ve,Kep,Ktrans,and ADC values(95%)was higher than that of a single diagnosis(69%,76%,73%,79%)(P<0.05).The specificity of Ve,Kep,Ktrans,and ADC combined diagnosis(80%)was compared with that of single diagnosis(77%,81%,82%,79%),there was no statistically significant(P>0.05).Conclusion The combined ADC values of Ve,Kep,and Ktrans can improve the diagnostic sensitivity of prostate cancer,and make up for the deficiency of a single diagnosis.

关 键 词：磁共振成像 前列腺肿瘤 扩散加权成像 表观弥散系数 前列腺癌 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]